The Experts below are selected from a list of 96 Experts worldwide ranked by ideXlab platform
Jungwon Hwang - One of the best experts on this subject based on the ideXlab platform.
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anesthetic management of a parturient with placenta previa totalis undergoing preventive uterine artery embolization before Placental Expulsion during cesarean delivery a case report
Korean Journal of Anesthesiology, 2014Co-Authors: Jae Woo Lee, In Ae Song, Junghee Ryu, Hee Pyoung Park, Youngtae Jeon, Jungwon HwangAbstract:Placenta previa totalis can cause life-threatening massive postpartum hemorrhage, and careful anesthetic management is essential. Preventive uterine artery embolization (UAE) before Placental Expulsion was introduced to reduce postpartum bleeding in cases of placenta previa totalis. We describe the case of a 40-year-old woman (gravida 0, para 0) with placenta previa totalis and uterine myomas who underwent intraoperative UAE, which was preoperatively planned at the strong recommendation of the anesthesiologist, immediately after delivery of a fetus and before removal of the placenta during cesarean delivery under spinal-epidural anesthesia. After confirming embolization of both uterine arteries, removal of the placenta resulted in moderate bleeding. The estimated blood loss was 2.5 L, and 5 units of red blood cells were transfused. The parturient was discharged uneventfully on postoperative day 4. This case shows that the bleeding risk is reduced by intraoperative UAE in a patient with placenta previa totalis, and anesthesiologists have an important role in a multidisciplinary team approach.
Erika F Werner - One of the best experts on this subject based on the ideXlab platform.
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timing of postpartum intrauterine device placement a cost effectiveness analysis
Fertility and Sterility, 2015Co-Authors: Chantel I Washington, Erika F Werner, Stephen F Thung, Roxanne Jamshidi, Unzila Ali Nayeri, Aaron B CaugheyAbstract:Objective To determine if immediate postpartum (PP) intrauterine device (IUD) placement prevents pregnancy and is cost-effective compared with routine placement. Design We developed a decision-analysis model to determine the number of pregnancies prevented and the cost-effectiveness of immediate PP IUD placement defined as within the first 10 minutes of Placental Expulsion compared with routine placement at the PP visit. Associated costs and probability estimates for adherence to PP follow-up, IUD placement, Expulsion, and pregnancy were determined from the literature. Setting Hospital and outpatient facility. Patient(s) Women desiring PP IUDs. Intervention(s) IUD placement. Main Outcome Measure(s) The main outcome measure was the number of pregnancies prevented per 1,000 women. The secondary outcome was an incremental cost-effectiveness ratio (ICER) defined as the marginal cost per quality-adjusted life-year (QALY) gained. An ICER of Result(s) Immediate PP IUD placement prevented 88 unintended pregnancies per 1,000 women over a 2-year time horizon. Immediate PP IUD placement was the dominant strategy. For every 1,000 women who desired a PP IUD, attempted immediate PP placement resulted in a cost savings of $282,540 and a gain of 10 QALYs. The model is most sensitive to the cost of an undesired pregnancy. When the cost of a live birth is Conclusion(s) Immediate PP IUD placement is a dominant strategy that prevents unintended pregnancy.
In Ae Song - One of the best experts on this subject based on the ideXlab platform.
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anesthetic management of a parturient with placenta previa totalis undergoing preventive uterine artery embolization before Placental Expulsion during cesarean delivery a case report
Korean Journal of Anesthesiology, 2014Co-Authors: Jae Woo Lee, In Ae Song, Junghee Ryu, Hee Pyoung Park, Youngtae Jeon, Jungwon HwangAbstract:Placenta previa totalis can cause life-threatening massive postpartum hemorrhage, and careful anesthetic management is essential. Preventive uterine artery embolization (UAE) before Placental Expulsion was introduced to reduce postpartum bleeding in cases of placenta previa totalis. We describe the case of a 40-year-old woman (gravida 0, para 0) with placenta previa totalis and uterine myomas who underwent intraoperative UAE, which was preoperatively planned at the strong recommendation of the anesthesiologist, immediately after delivery of a fetus and before removal of the placenta during cesarean delivery under spinal-epidural anesthesia. After confirming embolization of both uterine arteries, removal of the placenta resulted in moderate bleeding. The estimated blood loss was 2.5 L, and 5 units of red blood cells were transfused. The parturient was discharged uneventfully on postoperative day 4. This case shows that the bleeding risk is reduced by intraoperative UAE in a patient with placenta previa totalis, and anesthesiologists have an important role in a multidisciplinary team approach.
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vasovagal cardiac arrest during spinal anesthesia for cesarean section a case report
Korean Journal of Anesthesiology, 2013Co-Authors: Young Eun Jang, Sanghwan Do, In Ae SongAbstract:The vasovagal response is characterized by an inappropriate combination of bradycardia and paradoxical vasodilation. During a general or neuraxial anesthesia-induced sympathectomy, a sudden vagal activation and/or an acute reduction in sympathetic tone can cause serious vasovagal responses. Neuraxial anesthesia for Cesarean section may trigger vasovagal response, due to multiple risk factors; high neuraxial block, sudden hemorrhage, aortocarval compression, peritoneal manipulation, and emotional stress. A 39-year-old pregnant woman, at 38 weeks of gestation with episodes of non-sustained ventricular arrhythmia and newly developed vasovagal syncope during pregnancy, was scheduled to undergo a spinal anesthesia for an elective Cesarean section. Immediately after the Placental Expulsion, a sudden severe bradycardia, followed by a cardiac arrest occurred. The patient fully recovered after prompt cardiopulmonary resuscitation with chest compression, manual ventilation with oxygen, rapid injection of epinephrine and hydration. This case illustrates a serious potential risk of vasovagal response superimposed on neuraxial anesthesia, during a Cesarean section, especially during Placental Expulsion.
Y M Kabadi - One of the best experts on this subject based on the ideXlab platform.
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enhancing contraceptive usage by post Placental intrauterine contraceptive devices iucd insertion safety efficacy and Expulsion
Journal of Health Management, 2013Co-Authors: Hema Divakar, Jyoti Vajpyee, Ritu Joshi, Y M Kabadi, Sahaja KitturAbstract:More than 100 million women in developing countries would prefer to avoid a pregnancy; but they may not be using any form of contraception. Objective: The study was conducted to assess the safety incidence of perforation/pain/bleeding/foul discharge and Expulsion rates at 6 week follow-up and willingness to continue when Copper T 380A (Cu T 380A) inserted within 10 minutes of Placental Expulsion both in vaginal and C-section deliveries. Methods: This was an open label, prospective, and multicentric longitudinal study. The study was approved by the Ethics Committee of FOGSI. Results: The insertion of Intrauterine Contraceptive Devices (IUCD) was easy in 98.76 per cent of subjects after normal delivery, and 100 per cent in all subjects after assisted vaginal and c-section deliveries. The position of the Cu T was in situ in 97.61 per cent of subjects, ultra sonogram was used in 1 per cent to confirm location of IUCD and in 1 per cent of subjects the IUCD was in the cervix. There was no case of perforation in...
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enhancing contraceptive usage by post Placental intrauterine contraceptive devices ppiucd insertion with evaluation of safety efficacy and Expulsion
International journal of reproduction contraception obstetrics and gynecology, 2012Co-Authors: Sahaja Kittur, Y M KabadiAbstract:Background: More than 100 million women in developing countries would prefer to avoid a pregnancy; but they may not be using any form of contraception. The study was conducted to assess the safety, incidence of perforation /pain/bleeding/foul discharge and Expulsion rates at 6 week follow-up and willingness to continue when Cu T 380 A inserted within ten minutes of Placental Expulsion both in vaginal and C-section deliveries. Methods: This was an open label, prospective, and longitudinal study. The study was approved by the ethics committee of FOGSI. Results: The insertion of Intrauterine Contraceptive Devices (IUCD) at KIMS, Hubli was easy in 99.52% of subjects after normal delivery and 100% in all subjects after assisted vaginal deliveries. The position of the CuT was in situ in 94.78% of subjects, ultra sonogram was used in 24.76 % to confirm location where threads were not visible in the vagina and in 6.19% of subjects the tip of IUCD was in the cervix which was pushed back into the uterus using artery forceps. It was expelled in 5.23% of patients. There was no case of perforation in this series and no other major complications. Conclusions: Inserting CuT 380 A at 10 minutes after Placental delivery is safe leading to the expanding of the usage of IUCD meeting the unmet needs. The Expulsion rates would be minimal if it was inserted by a trained provider and placed at the fundus.
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research article enhancing contraceptive usage by post Placental intrauterine contraceptive devices ppiucd insertion with evaluation of safety efficacy and Expulsion
2012Co-Authors: Sahaja Kittur, Y M KabadiAbstract:Background: More than 100 million women in developing countries would prefer to avoid a pregnancy; but they may not be using any form of contraception. The study was conducted to assess the safety, incidence of perforation /pain/bleeding/foul discharge and Expulsion rates at 6 week follow-up and willingness to continue when Cu T 380 A inserted within ten minutes of Placental Expulsion both in vaginal and C-section deliveries. Methods: This was an open label, prospective, and longitudinal study. The study was approved by the ethics committee of FOGSI. Results: The insertion of Intrauterine Contraceptive Devices (IUCD) at KIMS, Hubli was easy in 99.52% of subjects after normal delivery and 100% in all subjects after assisted vaginal deliveries. The position of the CuT was in situ in 94.78% of subjects, ultra sonogram was used in 24.76 % to confirm location where threads were not visible in the vagina and in 6.19% of subjects the tip of IUCD was in the cervix which was pushed back into the uterus using artery forceps. It was expelled in 5.23% of patients. There was no case of perforation in this series and no other major complications. Conclusions: Inserting CuT 380 A at 10 minutes after Placental delivery is safe leading to the expanding of the usage of IUCD meeting the unmet needs. The Expulsion rates would be minimal if it was inserted by a trained provider and placed at the fundus.
Sahaja Kittur - One of the best experts on this subject based on the ideXlab platform.
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enhancing contraceptive usage by post Placental intrauterine contraceptive devices iucd insertion safety efficacy and Expulsion
Journal of Health Management, 2013Co-Authors: Hema Divakar, Jyoti Vajpyee, Ritu Joshi, Y M Kabadi, Sahaja KitturAbstract:More than 100 million women in developing countries would prefer to avoid a pregnancy; but they may not be using any form of contraception. Objective: The study was conducted to assess the safety incidence of perforation/pain/bleeding/foul discharge and Expulsion rates at 6 week follow-up and willingness to continue when Copper T 380A (Cu T 380A) inserted within 10 minutes of Placental Expulsion both in vaginal and C-section deliveries. Methods: This was an open label, prospective, and multicentric longitudinal study. The study was approved by the Ethics Committee of FOGSI. Results: The insertion of Intrauterine Contraceptive Devices (IUCD) was easy in 98.76 per cent of subjects after normal delivery, and 100 per cent in all subjects after assisted vaginal and c-section deliveries. The position of the Cu T was in situ in 97.61 per cent of subjects, ultra sonogram was used in 1 per cent to confirm location of IUCD and in 1 per cent of subjects the IUCD was in the cervix. There was no case of perforation in...
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enhancing contraceptive usage by post Placental intrauterine contraceptive devices ppiucd insertion with evaluation of safety efficacy and Expulsion
International journal of reproduction contraception obstetrics and gynecology, 2012Co-Authors: Sahaja Kittur, Y M KabadiAbstract:Background: More than 100 million women in developing countries would prefer to avoid a pregnancy; but they may not be using any form of contraception. The study was conducted to assess the safety, incidence of perforation /pain/bleeding/foul discharge and Expulsion rates at 6 week follow-up and willingness to continue when Cu T 380 A inserted within ten minutes of Placental Expulsion both in vaginal and C-section deliveries. Methods: This was an open label, prospective, and longitudinal study. The study was approved by the ethics committee of FOGSI. Results: The insertion of Intrauterine Contraceptive Devices (IUCD) at KIMS, Hubli was easy in 99.52% of subjects after normal delivery and 100% in all subjects after assisted vaginal deliveries. The position of the CuT was in situ in 94.78% of subjects, ultra sonogram was used in 24.76 % to confirm location where threads were not visible in the vagina and in 6.19% of subjects the tip of IUCD was in the cervix which was pushed back into the uterus using artery forceps. It was expelled in 5.23% of patients. There was no case of perforation in this series and no other major complications. Conclusions: Inserting CuT 380 A at 10 minutes after Placental delivery is safe leading to the expanding of the usage of IUCD meeting the unmet needs. The Expulsion rates would be minimal if it was inserted by a trained provider and placed at the fundus.
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research article enhancing contraceptive usage by post Placental intrauterine contraceptive devices ppiucd insertion with evaluation of safety efficacy and Expulsion
2012Co-Authors: Sahaja Kittur, Y M KabadiAbstract:Background: More than 100 million women in developing countries would prefer to avoid a pregnancy; but they may not be using any form of contraception. The study was conducted to assess the safety, incidence of perforation /pain/bleeding/foul discharge and Expulsion rates at 6 week follow-up and willingness to continue when Cu T 380 A inserted within ten minutes of Placental Expulsion both in vaginal and C-section deliveries. Methods: This was an open label, prospective, and longitudinal study. The study was approved by the ethics committee of FOGSI. Results: The insertion of Intrauterine Contraceptive Devices (IUCD) at KIMS, Hubli was easy in 99.52% of subjects after normal delivery and 100% in all subjects after assisted vaginal deliveries. The position of the CuT was in situ in 94.78% of subjects, ultra sonogram was used in 24.76 % to confirm location where threads were not visible in the vagina and in 6.19% of subjects the tip of IUCD was in the cervix which was pushed back into the uterus using artery forceps. It was expelled in 5.23% of patients. There was no case of perforation in this series and no other major complications. Conclusions: Inserting CuT 380 A at 10 minutes after Placental delivery is safe leading to the expanding of the usage of IUCD meeting the unmet needs. The Expulsion rates would be minimal if it was inserted by a trained provider and placed at the fundus.